Wang Lin, Wang Hui-Min, Tang Fan, Zhang Yan-Ting, Shi Rong-Rong, Wang Sheng-Hui, Liang Si-Chao, Gao Liao-Ming, Chen Zhi-Ting, Li Bao-Feng, Chen Bei
Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
Department of Imaging Diagnostics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
BMC Cancer. 2025 Mar 17;25(1):485. doi: 10.1186/s12885-025-13865-y.
In nasopharyngeal carcinoma (NPC) patients, two radiation target delineation patterns are used for the cervical lymph node area.
This study compares the efficacy and toxicity of two radiation target volume delineation patterns for planning target volumes (PTVs) in NPC patients.
This retrospective analysis included 387 non-metastatic NPC patients treated with concurrent chemoradiotherapy from January 2017 to December 2020. Patients were divided into two groups: the 2-PTV group with two dose gradients (50-54 Gy and 66-70 Gy) and the 3-PTV group with an additional 60-63 Gy dose.
After a median follow-up of 51.2 months, the 3-year regional relapse-free survival (RRFS) showed no significant differences between the 3-PTV and 2-PTV groups (96.6% [95% confidence interval (CI): 96.5%-96.8%] and 96.3% [95% CI: 96.2%-96.3%]). In the N3 subgroup, the 3-year RRFS was also comparable between the 3-PTV and 2-PTV groups (96.2% [95% CI: 76%-99%] vs. 95% [95% CI: 69%-99%], p = 0.727). Importantly, the 2-PTV group demonstrated significantly lower rates of grade 3/4 dermatitis (5.1% vs. 16.5%; HR 0.88, 95% CI: 0.82-0.94, p = 0.002) and xerostomia (49.6% vs. 67%; HR 0.78, 95% CI: 0.72-0.84, p = 0.002).
The 2-PTV regimen achieved equivalent survival outcomes while significantly reducing treatment-related toxicities compared to the 3-PTV approach. These results suggest that the 2-PTV strategy may offer a more favorable therapeutic profile for NPC patients, particularly in minimizing severe dermatitis and xerostomia.
在鼻咽癌（NPC）患者中，颈部淋巴结区域采用两种放射靶区勾画模式。
本研究比较鼻咽癌患者计划靶区（PTV）的两种放射靶区体积勾画模式的疗效和毒性。
本回顾性分析纳入了2017年1月至2020年12月期间接受同步放化疗的387例非转移性鼻咽癌患者。患者分为两组：2-PTV组采用两个剂量梯度（50-54 Gy和66-70 Gy），3-PTV组增加60-63 Gy剂量。
中位随访51.2个月后，3-PTV组和2-PTV组的3年区域无复发生存率（RRFS）无显著差异（96.6%[95%置信区间（CI）：96.5%-96.8%]和96.3%[95%CI：96.2%-96.3%]）。在N3亚组中，3-PTV组和2-PTV组的3年RRFS也相当（96.2%[95%CI：76%-99%]对95%[95%CI：69%-99%]，p = 0.727）。重要的是，2-PTV组3/4级皮炎（5.1%对16.5%；风险比0.88，95%CI：0.82-0.94，p = 0.002）和口干症（49.6%对67%；风险比0.78，95%CI：0.72-0.84，p = 0.002）的发生率显著较低。
与3-PTV方法相比，2-PTV方案在显著降低治疗相关毒性的同时，实现了相当的生存结果。这些结果表明，2-PTV策略可能为鼻咽癌患者提供更有利的治疗方案，特别是在将严重皮炎和口干症降至最低方面。
